Department of Gynecology, The Second Hospital of Dalian Medical University, Liaoning, Dalian 116021, China.
Third Department of Gynecology, Dalian Municipal Women And Children's Medical Center (Group), Liaoning, Dalian 116021, China.
Exp Gerontol. 2022 Mar;159:111682. doi: 10.1016/j.exger.2021.111682. Epub 2021 Dec 30.
Raloxifene treatment has been reported to be associated with cardiovascular benefits if prescribed to women during the postmenopausal period. However, a final conclusion regarding this hypothesis has not yet been achieved. We conducted a systematic review and meta-analysis to evaluate the effect of raloxifene on the endothelial function and inflammation in postmenopausal women.
We systematically searched the following 4 databases from inception to 23 January 2021 without any language restrictions: Web of Science, PubMed/Medline, Embase and Scopus. The eligible randomized controlled trials (RCTs) reporting the effects of raloxifene on the flow-mediated dilatation (FMD), C-reactive protein (CRP), carotid intima-media thickness (CIMT), intercellular adhesion molecule 1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1) and E-selectin levels, were included in the final meta-analysis.
A total of 16 RCTs were included in the final analysis. Raloxifene administration had no significant effect on ICAM-1 and E-selectin levels. However, we observed a decrease of the CIMT (WMD: -0.071 mm, 95% CI: -0.09 to -0.04, P = 0.000), CRP (WMD: -0.342 mg/L, 95% CI: -0.591, -0.094, p = 0.007), and VCAM-1 (WMD: -197.90 mg/L, 95% CI: -269.58 to -126.23, P = 0.000) levels in the intervention versus control groups following the prescription of this pharmacological agent. Moreover, raloxifene treatment resulted in a significant elevation of the FMD (WMD: 1.64%, 95% CI: 0.46 to 2.81, P = 0.006), particularly if the intervention was equal to or exceeded 12 weeks.
Raloxifene might emerge as a potential therapeutic option in the management of endothelial dysfunction and inflammation in postmenopausal women.
已有报道称，雷洛昔芬治疗如果在绝经后期间用于女性，与心血管益处相关。然而，对于该假说还没有得出最终结论。我们进行了系统评价和荟萃分析，以评估雷洛昔芬对绝经后女性内皮功能和炎症的影响。
我们从创建至 2021 年 1 月 23 日系统地搜索了以下 4 个数据库，没有任何语言限制：Web of Science、PubMed/Medline、Embase 和 Scopus。纳入最终荟萃分析的合格随机对照试验（RCT）报告了雷洛昔芬对血流介导的扩张（FMD）、C 反应蛋白（CRP）、颈动脉内膜中层厚度（CIMT）、细胞间黏附分子 1（ICAM-1）、血管细胞黏附分子 1（VCAM-1）和 E-选择素水平的影响。
共有 16 项 RCT 纳入最终分析。雷洛昔芬治疗对 ICAM-1 和 E-选择素水平没有显著影响。然而，我们观察到 CIMT（WMD：-0.071mm，95%CI：-0.09 至-0.04，P=0.000）、CRP（WMD：-0.342mg/L，95%CI：-0.591，-0.094，p=0.007）和 VCAM-1（WMD：-197.90mg/L，95%CI：-269.58 至-126.23，P=0.000）水平在干预组与对照组之间均有下降。此外，雷洛昔芬治疗可显著提高 FMD（WMD：1.64%，95%CI：0.46 至 2.81，P=0.006），尤其是干预持续 12 周或以上时。
雷洛昔芬可能成为绝经后女性内皮功能障碍和炎症管理的潜在治疗选择。
